Objectives Medical compression therapy is used for non-invasive treatment of venous and lymphatic diseases. Medical compression therapy-associated adverse events and contraindications have been reported, although some contraindications are theoretically based. This consensus statement provides recommendations on medical compression therapy risks and contraindications. Methods A systematic literature search of medical compression therapy publications reporting adverse events up until November 2017 was performed. A consensus panel comprising 15 international experts critically reviewed the publications and formulated the recommendations. Results Sixty-two publications reporting medical compression therapy adverse events were identified. The consensus panel issued 21 recommendations on medical compression therapy contraindications and adverse event risk mitigation, in addition to reviewing medical compression therapy use in borderline indications. The most frequently reported non-severe medical compression therapy-associated adverse events included skin irritation, discomfort and pain. Very rare but severe adverse events, including soft tissue and nerve injury, were also identified. Conclusion This consensus statement summarises published medical compression therapy-associated adverse events and contraindications, and provides guidance on medical compression therapy. Severe medical compression therapy-associated adverse events are very rarely encountered if compression is used correctly and contraindications are considered.
Venous ulcer is an extremely common aetiology of lower extremity ulceration, which affects approximately 1% population in most of the countries, and the incidence rate increases with age and female gender. Proper assessment and diagnosis of both the patient and ulcer are inevitable in order to differentiate venous ulcers from other lower extremity ulceration and to frame an adequate and individualised management plan. Venous ulcers generally persist for weeks to many years and are typically recurrent in nature. This consensus aims to present an evidence-based management approach for the patients with venous ulcers. Various management options for venous ulcers include compression therapy, minimally invasive procedures like sclerotherapy and ablation techniques, surgical procedures, debridement and medical management with micronised purified flavonoid fraction (MPFF). Compression therapy is the mainstay treatment for venous ulcer. However, in failure cases, surgery can be preferred. Medical management with MPFF as an adjuvant therapy to standard treatment has been reported to be effective and safe in patients with venous ulcer. In addition to standard therapy, diet and lifestyle modification including progressive resistance exercise, patient education, leg elevation, weight reduction, maintaining a healthy cardiac status and strong psychosocial support reduces the risk of recurrence and improves the quality of life in patients with venous ulcer.
Six coordination polymers with aliphatic dinitrile ligands, {[Ag(cpdcn)2]ClO4}n (6a), {[Ag(cpdcn)2]PF6}n (6b), {[Ag(cpdcn)2]SbF6}n (6c, cpdcn = cis-1,3-cyclopentanedicarbonitrile), {[Ag(bcmcp)2] ClO4}n (7a), {[Ag(bcmcp)2]PF6}n (7b), {[Ag(bcmcp)2]SbF6}n, (7c, bcmcp = cis-1,3-bis(cyanomethyl)cyclopentane) have been synthesized and structurally characterized by IR spectroscopy, differential scanning calorimetry (DSC), thermogravimetric analysis (TGA) and X-ray crystallography. Both ligands used in this study are meso-compounds; while the ligand cpdcn is structurally rigid, the ligand bcmcp has greater conformational flexibility. X-ray crystallography has revealed that structures 6a-c consist of chiral 1D-polymers. The structure of complexes 7a and 7b are best described as a 2D chiral (4,4) square mesh with 3-fold parallel interpenetration. Surprisingly, complex 7c was characterized to be an achiral 1D coordination polymer. The synthesis of the ligands, IR spectra of the free and coordinated CN groups, DSC and TGA, and the photoluminescent properties of complexes 6a-c and 7a-c are also discussed.
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